How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $20.42 Median $56.23 Typical High $69.18 | Facility | None | $20.42 | $56.23 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $263.03 | Professional | None | $20.42 | $20.42 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $51.29 Typical High $91.20 | Facility | None | $32.36 | $51.29 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.89 Typical High $46.77 | Professional | None | $20.42 | $20.89 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $67.61 | Facility | None | $38.02 | $43.65 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $89.13 | Professional | None | $20.42 | $20.42 | $89.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $38.02 Median $58.88 Typical High $67.61 | Facility | None | $38.02 | $58.88 | $67.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $89.13 | Professional | None | $20.42 | $20.42 | $89.13 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $39.81 Typical High $53.70 | Professional | None | $25.70 | $39.81 | $53.70 |
SummaCare Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $40.74 | Professional | None | $20.42 | $22.39 | $40.74 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | None | $32.36 | $32.36 | $47.86 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.23 Typical High $131.83 | Professional | 52 · Reduced service | $10.23 | $10.23 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $53.70 | Professional | 53 · Discontinued | $4.07 | $4.07 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $39.81 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $26.30 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $26.30 |
Where Ohio sits
The same service costs 3.8 times more in Oklahoma than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 20th of 51
$32.36
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.